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Sorafenib in combination with transarterial chemoembolization improves survival of unresectable hepatocellular carcinoma A propensity-score matching study



Sorafenib in combination with transarterial chemoembolization improves survival of unresectable hepatocellular carcinoma A propensity-score matching study







This prospective non-randomized controlled trial was aimed to compare the efficacy of sorafenib in combination with transarterial chemoembolization (TACE) versus TACE alone for treatment of patients with unresectable intermediate/advanced stage hepatocellular carcinoma (HCC). A total of 304 patients were enrolled and all treated with TACE, 82 of the patients received concurrent sorafenib (400 mg orally twice daily initiated within 7 days after TACE), and these patients were matched with 164 patients who received TACE alone at a 1:2 ratio using propensity-score matching to minimize selection bias. The response to treatment, time-to-progression (P), overall survival (OS) as well as adverse effects were compared between the two groups. During a median follow-up period of 21.4 weeks (range 0.5-103 weeks), the addition of sorafenib improved P from 4.3 months to 6.3 months (hazard ratio [HR] 0.60, 95% CI 0.422-0.853, P = 0.004) and prolonged median survival time from 5.1 months to 7.5 months (HR 0.61, 95% CI 0.423-0.884, P = 0.009). Significant prognostic factors for OS by multivariate analyses included the use of sorafenib, BCLC stage, metastasis/vascular invasion, and liver function. The combined use of sorafenib and TACE was generally well-tolerated and significantly improved the overall survival, P, as compared to TACE alone. Further studies are warranted to confirm the safety and efficacy of this combination.

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Accession: 036731759

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DOI: 10.1111/1751-2980.12038


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